Coagulation-fibrinolysis Activation In Patients With Binswangerdisease

Background and Purpose: The alterations of blood vessel endothelial cell, function of the platelet, coagulation -fibrinolysis system and blood rheology result in the hypercoagulable state . D-dimer is the hemostatic markers of the hypercoagulable state. Although hypercoagulable state is known to be in the acute stage of cerebral infarction, coronary heart disease, DIG, etc, however, in Binswanger disease (BD), no information is available on the coagulation-fibrinolysis pathway except for the presence of high plasma fibrinogen levels. Methods: We examined the levels of cross-linked D-dimer in 49 patients with BD and 46 healthy age-matched subjects with enzyme-linked immunosorbent assays. The levels of fibrinogen ,triglyceride and glucose were also examined. Results: (1) There was no significant difference in age and sex between the BD and healthy controlled group. Hypertension, high triglyceride and diabetes mellitus were more frequent in the BD group than in the controlled group (P<0.01, 0.05, respectively) . patients with BD had significantly increase in triglyceride and glucose levels compared with the controlled group(P<0.01,0.05,respectively).Patients with BD had significantly elevated levels of cross-linked D-dimer and fibrinogen (P<0.01) compared with the controlled group.(2)In the BD group , 27 patients in deteriorating condition (ie, those with recent obvious neurologic deficits in the past 3 months) had a high ratio of hypertention than the stable group (ie, those without recent obvious neurologic deficits in the past 3 months)( p<0.05) .The deteriorating group Showed a significant increase in levels of cross-linked D-dimer and fibrinogen compared with the stable group, but this tread didn't reach statistical significance (p>0.05). Levels of triglyceride and glucose were also compared in patients in the subgroup of BD, the increase of levels of triglyceride and glucose didn't reach the statistical significance (P>0.05). (3) Hypertension, age , level of D-dimer are the independent risk factors of BD. Age and BD are assoctioned with the level of D-dimer(r=0.435,0.308,p<0.01) .Conclusions: The levels of D-dimer and fibrinogen in BD patients are increased. The results indicate that the coagulation fibrinloysis pathway is activated in patients with BD. The coagulation fibrinolysis activoaion may result in the formation of microthrombi and microcirculatory disturbances in the brains of these patients , and thus promote further biological and neurologic insults. D-dimer, hypretension and age are the independent risker factors of BD . High levels of fibrinogen, triglyceride and glucose aren't the independent risker factors of BD. The level of D-dimer is associated with age and BD.